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All posts by Kristen Pavle

Kristen is a licensed social worker currently living and working in Chicago, Illinois. She works as a policy analyst for Health & Medicine Policy Research Group, Center for Long-Term Care Reform. Her work focuses on assuring Illinois achieves an affordable, accessible, comprehensive and adequate long-term care system that is responsive to older adults, and reflects predominantly home and community based care.

What is Long-Term Care and What are Long-Term Services and Supports?

LTC covers a broad range of services and supports for individuals requiring medical and/or social care over an extended period of time.

This includes activities of daily living like feeding and bathing; and instrumental activities of daily living like grocery shopping and doing laundry.

Long-term supports and services (LTSS) can be delivered in two main areas: institutions (like nursing facilities) or the home and community based setting.

Currently there is a focus in the United States to ‘balance’ the LTC system; historically long-term care has been institutionalized. We are moving towards a more balanced LTC system, and eventually towards a primarily home and community based LTC system.

Over time through technological advances, people are living longer and care is able to be provided in a home and community based setting (HCBS).

These rankings were achieved by looking at several indicators per category; for the full explanation for how they computed these findings check out the methodology site here. For example, if you look at the Affordability and Access category for Illinois, you see Illinois’ measurements for 6 indicators. From median cost for a private-pay nursing home stay to the ability to access LTSS through a single point of entry like the Aging and Disability Resource Center.

Specific Findings for Illinois: What Did You Find?

One thing that I found interesting is that Illinois ranks the lowest for providing nursing home care for people with low-care needs. Illinois measured at providing low-care needs for 25.1% of the nursing home population, as compared to Maine who ranked the highest at 1.3%. This is one area that Illinois can improve it’s long-term care system. On the main “Raising Expectations” website, there is a great interactive function where you can compare different states on a variety of different indicators; it’s labeled “Browse the Score Card” on the right hand side of the screen.

I recommend checking it out yourself and sharing what you find here. Is there anything else that Illinois has ranked at the top or bottom? What have you found where Illinois is a leader to follow, or has room to reform?

Special thanks to Bridget Murtha for editing this article; and to pjern on flickr.com for the photo.

You might be wondering why I am bringing this Budget Proposal up now. Currently, the United States government is on an August 2nd, 2011 deadline, when the nation’s debt ceiling will be reached. Most people agree we must raise the debt ceiling in order to avert negative economic consequences. However, raising the debt ceiling requires a Congressional vote, and many Congressmen feel that federal spending is out of control. In order to win votes to raise the debt ceiling, Congress has resorted to bartering: conservatives are offering a vote to raise the debt ceiling, but only if federal spending is curbed.

Healthcare spending is one of the largest and fastest growing federal expenditures and much focus has landed on cutting back this sector. Thus, reforming Medicare and Medicaid have become part of the compromise to raising the debt ceiling. One of the main ways that the Ryan budget proposes to cut federal spending is by reforming Medicare and Medicaid.

While the Ryan Budget Proposal may not pose a real threat in that it will be passed as law, the themes throughout the document in how to approach health and financial reform are common in current Congressional debates. In this blog post I will share with you what these ‘reforms’ mean for Medicare and Medicaid recipients.

Medicare Reform in the Ryan Plan

Let’s start with Medicare Reform. The Path to Prosperity suggests that the Medicare system should be completely reformed, and that Medicare payments would no longer be directly billed to physicians, hospitals or doctor’s offices. Instead, Medicare recipients (including individuals 65 years and older) would purchase private health care services from numerous insurance company options on a healthcare exchange. The federal government would subsidize a certain amount of health care expenditures—essentially older adults and other Medicare beneficiaries would be given a voucher for health care expenditures. Outside of the voucher payments, or health care subsidies, health care expenses would be the responsibility of the individual.

Well, I am not sure what’s to like about this reform—the proposed cuts to the Medicare program shift financial responsibility from the federal government to older adults to deal with themselves. There is no guarantee that these vouchers will grow in value as quickly as healthcare costs are projected to rise. And let’s not forget: Medicare is currently more efficient than the private health insurance market. If we privatize Medicare, like the Ryan proposal suggests, health care costs will actually increase because private health care insurance is more expensive than Medicare. I understand the need to reform Medicare, but the Path to Prosperity merely shifts the cost burden to Medicare beneficiaries.

Medicaid Reform in the Ryan Plan

Representative Ryan’s proposal to reform Medicaid would mean turning Medicaid into a block grant program. What exactly does that mean? Right now Medicaid is a matching program: states spend a certain amount of money on Medicaid services and the federal government matches this amount. The Path to Prosperity proposes to change this financing mechanism and give each state an annual lump sum of Medicaid dollars. This offers the state the flexibility of designing its Medicaid program to fit its unique population—setting its own eligibility and standards. It is important to note that Medicaid is the largest payer of long-term care services, which is quite important to over 9 million older adults (and this number is growing with the population growth of older Americans).

However, block-granting Medicaid is a dangerous proposal when it comes to ensuring that health care is accessible and affordable. With a block grant, states are given a finite amount of money and looser guidelines of how to use that money. With the current funding mechanism, the federal government matches states’ spending in an on-going manner as Medicaid services are rendered. What would happen if more people were eligible for Medicaid and needed to access services, as is typical in an economic downturn? In a block-grant funding situation, more people would be seeking services paid from a fixed ‘block’ of money. Then what? How would the state decide which services to provide, or who to serve? Would the state have to raise taxes in order to generate enough revenue to provide services? Would the state simply start denying coverage? Answers to these questions would be the state’s responsibility.

What we do know is that the cost growth of Medicaid is rising faster than the Ryan proposal’s Medicaid block-grant inflation would account for. This means that the block grant funding would not keep pace with health care costs, leaving states shouldering the Medicaid cost burden. Once again, costs are shifted from the federal government to the individual; in this case the individual as seen as a citizen of one of our states.

Do You Want to Be a Part of the Conversation?

Here’s the easy part! If you want your voice to be heard, call your Senator or Representative in D.C. If you agree or disagree with cutting Medicare and Medicaid; if you like or dislike the Affordable Care Act—let your elected officials know. The threat right now is not the Ryan Budget Proposal, but threats to Medicare and Medicaid. Over the past few weeks our Congressmen’s offices are receiving many calls and emails on the debt ceiling. It is important for our elected representatives to know what our opinions are, as constituents.

You may have heard the buzz about care transitions as an aging professional, or health care professional, or even if you are simply keeping up on current events. Transitions in care are a form of care coordination during a transitional event. Care transitions are broadly defined. Here are a few examples: transitioning within a hospital from the emergency room to an in-patient floor; transitioning from a nursing home back home; transitioning from private payer health insurance to Medicare. Right now the focus is on the transition from the hospital—and there’s good reason for this. Here’s a few key numbers to explain why:

$17.4 Billion

According to the same article referenced above, the cost of the readmissions for Medicare beneficiaries totaled $17.4 Billion for one year! This is almost 17% of the $102.6 billion that Medicare reimbursed hospitals for the year of the study. With health care costs in the United States continuing to increase, care transitions are understandably an identified area for health care systems improvement.

$500 Million

In accordance with section 3026 of the Affordable Care Act, CMS made $500 Million available for the new Community Care Transitions Program (CCTP). CCTP is a unique funding opportunity for community-based organizations (CBOs) to lower readmissions to the hospital. CBOs are able to apply for reimbursement of care transition service provision through a Medicare fee-for-service mechanism. CCTP requires CBO partnership along the continuum of care including: hospitals, skilled nursing facilities, home health agencies and more.

2014

The Illinois Hospital Association is partnered with Blue Cross Blue Shield of Illinois to address high hospital readmission rates through the “PREP” Program. PREP stands for Preventing Readmissions through Effective Partnerships, and 201 hospitals in Illinois have pledged to lower hospital readmissions in the state by 2014. One of the five initiatives of the PREP Program is improving transitions of care.

3025

Section 3025 of the Affordable Care Act introduces penalties to hospitals for preventable readmissions. Starting in 2013, Section 3025 allows CMS to withhold up to 1% of Medicare payment reimbursement to hospitals. By 2015, up to 3% of Medicare reimbursement to hospitals may be withheld due to preventable readmissions. This means that hospitals that do not improve their readmission rates will receive an overall reduced Medicare reimbursement from CMS. For medium to large hospitals, a 1% reduction in reimbursement is estimated to cost from $500,000 to $1,000,000 in lost revenue. If hospitals don’t figure out how to lower readmissions, it is going to cost them a lot of money.

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Let’s take a look at what’s happening in Illinois with care transitions from the hospital. The Illinois Transitional Care Consortium (ITCC) wasformed to more effectively address needs of older adults transitioning from the hospital to the community by linking hospital based services with the aging network through intensive care coordination. ITCC consists of 12 partners: community-based organizations, hospitals, a university research facility, and a policy and advocacy research organization. ITCC developed the Bridge Model: a unique social work led model of transitional care that builds upon the Care Coordination Unit (CCU) system and Aging Network in Illinois. ITCC is currently developing a proposal for funding through the Community Care Transitions Program (CCTP), described above.

About a year ago, in February 2010, the Chicago Bridge hosted a monthly event about aging services and long-term care. The vast world of long-term care was explored and Bridge members were inundated with acronyms for programs, services, and departments. In this post, I will add another long-term care acronym or two to your lexicon as I describe the Aging and Disability Resource Center Program (ADRC), a joint effort of the Administration on Aging (AoA) and the Centers for Medicare & Medicaid Services (CMS).

ADRC’s are currently a federal grant funded, single-point of entry to the long-term supports and services system for both older adults and persons with disabilities. ADRCs aim to integrate and coordinate long-term supports and services, a system that is quite complex and thus difficult to navigate. The main goals of ADRCs are to make the diverse range of long-term care options easier to understand, assist consumers to make informed decisions on what kind of services and supports they may need, and help people to gain access to long-term supports and services. The definition, functions, and vision for ADRCs can be found in the Older Americans Act.

Medicare Outreach and Assistance in Low Income Programs and Prevention Grants: $1,499,253.

ADRC Options Counseling Grants: $457,160

Evidence Based Care Transition Grants: $197,656

The Evidence Based Care Transitions Grant in Illinois was awarded to the Illinois Department on Aging, AgeOptions, and the Illinois Transitional Care Consortium. The Care Transitions model is the Bridge Model.

ADRCs and Care Transitions

The Program Announcement for the ADRC Evidence Based Care Transition Program explains the issue of rehospitalization after discharge from a hospital. According to a research study*, 1 out 5 Medicare beneficiaries is rehospitalized within 30-days of hospital discharge, and 1 out 3 within 90-days. In 2004, these readmissions are estimated to have cost $17.4 billion to Medicare! Many of these readmissions are potentially avoidable, and care coordination and transitions in care have become a way to address the high rate of hospital readmissions. Accordingly, policy makers, federal and state governments, and aging service providers have made care coordination and care transitions a priority.

Care transitions have become a focal point in health reform discussions as a way to provide better care and bend the cost curve. In conjunction with ADRCs, it is now being demonstrated through this AoA funded project that care transitions offer an opportunity to reach older adults and persons with disabilities. Through care transitions programs, consumers are introduced to the long-term care system, the Aging Network, and the disability network of programs and services.

In Illinois, our Aging Network is unique: we have a Case Coordination Unit (CCU) system. The Illinois funded Evidence Based Care Transition Program capitalizes on the CCU system: the Bridge Model was developed by the Illinois Transitional Care Consortium to build off of the strengths of the CCU system, connecting older adults being discharged home from the hospital with long-term supports and services through the Aging Network. For readers interested in transitions in care, stay tuned to the Chicago Bridge blog—I will be covering this topic in greater detail for a future post.

The Future of ADRCs

ADRCs are a relatively new venture for the United States, having started in 2003. With the current ADRC demonstration projects on care transitions and other ADRC grant funded projects for options counseling, ADRCs are in a time of expansion. ADRCs are making long-term supports and services accessible, easier to understand, and consumer-centered. The United States is notorious for its ‘patchwork’ of health and long-term care services. Although I would argue that the only answer to coordinating all of these programs, supports and services is a single-payer healthcare system, I will admit that ADRCs are a step in the right direction.

On March 23, 2010, Congress passed the historic health care overhaul bill: the Patient Protection and Affordable Care Act (PPACA). Subsequently, the Health Care and Education Reconciliation Act was passed, making small changes to PPACA. These two bills together are now frequently referred to as: the Affordable Care Act (ACA). Although the House of Representatives successfully voted to repeal the ACA in January, 2011, the Senate has said they would not vote on such a repeal (as the Senate is Democrat controlled, it would likely not pass), and President Obama has vowed not to sign a repeal of the ACA.

The attempt to repeal the ACA by the House in January was largely a political demonstration of partisan power; and the conversation about the future of the ACA is not yet concluded. Even though a formal repeal of the ACA has not pushed through Congress, political tactics to break down the bill will ensue: conservatives will try to dissemble the bill and liberals will advocate for its preservation. While I will not go into specifics about the political song-and-dance that will undoubtedly emerge in Congress as the future of the ACA is debated, I do want to share with you what older Americans will lose if the ACA is not protected.

Better Medicare Benefits with the Affordable Care Act

One essential point that should be addressed up front regarding the ACA and older adults: basic Medicare benefits will not be cut. Some coverage may change for older adults, but overall the ACA betters the Medicare benefit package in several important ways. One of the most noteworthy ways the ACA helps older adults is by filling the ‘donut hole’– the Medicare Part D subscription drug benefit requires older adults to cover their prescription drugs out of pocket once they hit $2,830 in drug costs, until $6,440 in drug spending is reached. As a result of the ACA: in 2010, all older adults who had fallen into the donut hole were cut a check for $250 from Medicare; in 2011 Medicare recipients in the donut hole will only be required to pay half of the charges for brand-name drugs; and by 2020, the donut hole will be completely eliminated through a series of slow changes.

Medicare covered 38.7 million Americans aged 65 and older in 2009, according to the 2010 Medicare Trustees Report. The baby boom generation will cause rapid growth of both individuals served through Medicare and growth in Medicare costs. The ACA helps to strengthen Medicare and ensure its stability over the long-term—an essential reform to our health care system if we want to continue to provide our growing population of older adults with quality, affordable health care supports and services.

The Affordable Care Act and Aging in Place

The ACA will make it easier to provide long-term care services in a home and community based setting. Long-term care, however, is not primarily Medicare covered, but Medicaid covered. In February of 2009, the Chicago Bridge monthly event featured Amy Wiatr, of the Administration on Aging, who discussed long-term care and the concept of long-term care reform at length. Long-term care, or the need for assistance with activities-of-daily-living (ADLs), is needed due to a disability or chronic condition—and the incidence of both increases with age.

Extension of the Money Follows the Person (MFP) Rebalancing program. MFP was originally introduced through the Deficit Reduction Act of 2005 and assists people living in nursing homes to transition back into the community. Funding was originally slated to expire in 2011, but the ACA extends MFP through 2016. (Of note, Illinois has been a part of Money Follows the Person since 2007).

The introduction of the Community First Choice Option: a Medicaid state plan option to pay for long-term services and supports in a community setting.

Spousal impoverishment protection for Medicaid beneficiaries receiving home and community based long-term services and supports.

And lastly, there is the Community Living Assistance Services and Supports, or CLASS, Act, a long-term care insurance program that was introduced in the ACA. The CLASS Act is a voluntary insurance program administered by the federal government that will provide a cash benefit to people who require long-term care assistance in a home or community-based setting. While the eligibility details, rules, and regulations are forthcoming for the CLASS Act, this ACA provision represents a move forward to addressing the growing long-term care needs that aging and disabled Americans experience on a daily basis.

What to Expect with the Affordable Care Act in the Future?

As some members of Congress continue their attempts to breakdown the ACA, others will oppose this action. Over the next year, expect a lively debate on the appropriation of funds for the ACA; this means small, frequent battles to keep the ACA alive and able to benefit the health of older Americans.

While I cannot predict exactly how these debates will unfold, nor can I predict what the final outcomes or votes will be, I do know that the Affordable Care Act supports health care provision to older Americans in a more comprehensive, preventive, effective, affordable, and accessible manner. My advice? Let’s stop fighting the Affordable Care Act, and figure out how we can help implement the provisions of the bill to ensure that all Americans, including older adults, have the opportunity to receive adequate health care.

Call for Applications: Chicago Bridge Mentorship Program

The Chicago Bridge is excited to announce our 2nd launch of the Mentorship Program.

The six-month Chicago Bridge Mentorship Program matches emerging and experienced professionals in the field of aging to ensure sustainable growth of an elder-care workforce prepared to meet the needs of Chicago’s diverse older adult population. Mentors and Mentees meet at least monthly with the goal of helping Chicago Bridge members develop their skills, network, and confidence. The Program builds a structure for passing the knowledge and skills of seasoned professionals to the next generations of leaders in the field of aging.

There seems to be a growing opinion among 20 and 30 year olds about the United States Social Security program: that it will not exist upon our retirement, so why should we care? Perhaps I am missing something here, but the mere fact that we are paying into the Social Security program NOW, for others’ benefits, is reason enough to care! I want this program to exist in my retirement, too. But even this is only a minor reason to become more involved in the discussion surrounding Social Security as a younger person.

As of 2006, the Social Security program has provided more than $541.6 Billion dollars in benefits to over 49 million individuals. Social Security allows citizens of this country to retire with the earned privilege—an enforceable right—of an income after a lifetime of work. Social Security retirement income, with benefits also paid to spouses, widows (or widowers), minor children, and people with disabilities represents a fundamental cornerstone of our society. Because of Social Security, older Americans are no longer the poorest demographic in the country. It is the most visible symbol of intergenerational connectedness and the last remaining leg of the three-legged stool (savings, pensions, and Social Security) that its founders envisioned. Today it is the bedrock of economic security, particularly in old age, for thousands of people, especially older women. Not only do I urge you to care about Social Security, but I want to start the discussion on WHY we should all care about the concept of “social security” as manifested by the Social Security program.

By 2016 the benefits program will be paying out more than it will be gaining in revenues, thus beginning to deplete the trust fund.

By 2024 the Social Security pot of money, the trust fund, will no longer be growing.

By 2037 the Social Security trust fund will be exhausted, empty, no money left. But income will still be coming into the system from payroll taxes so benefits will be paid but at a reduced amount.

Maybe your parents were right…? But, these figures about financing Social Security in the long-term function under a rather large assumption: that there will be no structural changes in how the Program operates. However, last time I checked we live in a democratic nation. As citizens, we have a choice to demonstrate our commitment to Social Security so that benefits can be available IN FULL when we retire.

Advocates for Social Security are equipped with many ideas for how we can change the structure by which the Program operates, giving it full financial sustainability beyond 2037, when WE retire. Social Security’s problems are political, not financial. Contrary to popular opinion it is not in crises; it does not contribute a single penny to the deficit. In fact, it is in surplus.

A Call for Your Voice to be Heard: Focus Group

In an attempt at brevity, I will close this blog article with an invitation to continue the discussion. Health & Medicine Policy Research Group (HMPRG) wants to talk with you. HMPRG will be hosting a focus group for individuals in their 20s and 30s on Social Security. We look to you to help us build a campaign to get all younger people committed to Social Security’s robust survival. Quite honestly, we want to turn you into an informed advocate for a strong Social Security program, one that will be there for each succeeding generation. Remember, it is the only source of income that you cannot outlive.

Are you in your 20’s or 30’s?

Do you have an opinion on Social Security?

Do you have questions about Social Security or an interest to learn more?

On Wednesday, July 28th from 6-8pm, HMPRG will host a focus group to garner your thoughts about Social Security. Please contact me at KPavle@hmprg.org for details and to RSVP.

On Wednesday, June 16th, 2010, the Chicago Bridge hosted its first Older Adult Panel Discussion. The discussion surrounded the theme, “Empowered Aging, Stories of Strength”. This June event was held at Little Brother’s Friends of the Elderly (LBFE), and the panelists were all clients of LBFE. LBFE is a non-profit, volunteer-based organization dedicated to relieving isolation and loneliness among older adults. Their motto is “flowers before bread”, and as one of the panelists explained, this means that a person’s soul must be addressed along with the basic necessities in life. All of the panelists agreed that they did not know what to expect from this event, but they trusted LBFE would show them a good time.

The evening started off with LBFE serving a home-made meal of Caesar salad, and an opportunity for Chicago Bridge members to network. The event drew 26 Bridge members, many representing LBFE. After the group sat down to enjoy their food, we began with the typical Bridge introductions. Susan Jones, the fabulous coordinator of the event at LBFE, then told the group about LBFE and the services offered.

The panelists, 6 in total, introduced themselves and shared their age and how long they had been involved with LBFE. There were two men and four women on the panel, their ages ranging from late 60’s to mid-80’s. Most of the panelists had a 2-5 year history with LBFE. Susan Jones and I served as moderators, asking questions of the panelists to make sure the conversation kept moving. Several Bridge members had questions of their own that they asked the panelists as well.

The panelists really showed the group what aging gracefully means, and were true to the theme of the evening, “Empowered Aging, Stories of Strength”. Each panelist acknowledged that they are accepting of aging and that they have learned to go with the flow of life, not to fight it. There was laughter and jokes told, and tears over loved ones lost. We talked about how we all need someone to talk to, or walk with, in life; that it is so important not to isolate and be alone as one ages. The panelists shared that age does not matter, it is the person that matters, and that they welcome a younger cohort of professionals to help them age gracefully. The panelists all maintain that they’ve kept their personalities throughout life, and the biggest life changes have been around their health.

As our panel discussion came to an end, it was clear that everyone had enjoyed their time together. There were a lot of smiles and a round of applause. Several panelists stayed behind for a while to talk with Chicago Bridge members. One Chicago Bridge member, Caren Jeskey, summarizes the June event nicely, “The Older Adult Panel Discussion was a touching and motivational experience. The elders shared their wisdom with us, and helped us see what aging gracefully is all about. Rather that being a lecture about how to be a better social worker, it was an exercise in humanity that brought us all closer together and closer to goodness. I left there feeling inspired and full of hope. Thank you panelists!”

The Social Security entitlement program in the United States has a long history; President Franklin D. Roosevelt signed it into law in 1935, passing Congress as part of the New Deal. Social Security is a social insurance program for retired persons, disabled individuals, and individuals who depended on a family worker who has died. Social Security is a safety net for many Americans, and specifically many older adults. With more than 47 million Americans depending on Social Security income, and over two-thirds of retirees relying on Social Security for the majority of their income, it is imperative we protect and strengthen the Social Security program. As the National Commission on Fiscal Responsibility and Reform continues to meet, behind closed doors, advocacy to preserve Social Security must be a priority.

The True Cost of Living for Older Adults, Illinois Perspective

Wider Opportunities for Women (WOW), a non-profit based out of Washington D.C., created the Elder Economic Security Initiative (EESI) several years ago. EESI approaches building economic security through advocacy, organizing, and research. A key part of EESI is the Elder Economic Security Standard™ Index, calculating the cost of living for an older adult. The Illinois state partner for EESI is Health & Medicine Policy Research Group (HMPRG) and detailed information about EESI can be found on the HMPRG website. In Illinois, and across the country, EESI is revealing that frequently older adults cannot make ends meet based on their income and the cost of living.

According to the policy brief, “Elders Living on the Edge: When Meeting Basic Needs Exceeds Available Income in Illinois”, in Illinois 1 out of 5 older adults relies solely on Social Security. Unfortunately, the average Social Security payment for a single, retired Illinoisan does not cover the cost of living. Using EESI as a tool, specifically the data of the Elder Economic Security Standard™ Index, Illinoisans can advocate in many ways to protect the economic security of its older adult population. One way is to advocate for the strengthening and preservation of the Social Security program. With so many older adults in Illinois relying on Social Security and currently unable to afford the cost of living in the community, any disruption of Social Security benefits would be tragic.

Without providing payment to state-funded social service agencies, many older adults will not be able to access the services they need to remain healthy and viable in their communities. As the Federal Commission researches ways to balance the federal budget and talk of changing Social Security continues, the economic well-being of older adults has never been a more pertinent issue.

Do you have anything to contribute to this conversation about the federal deficit?

About Illinois’ budget deficit?

About cuts to social service programs in Illinois?

About preserving Social Security?

How do potential budget cuts affect you?

Please leave your comments below. HMPRG is working with WOW to make sure that your voice is heard, that the Federal Commission and the Illinois state government knows that their decisions affect you. Our country, and our state of Illinois, is in difficult times. Now is not a time to be quiet, but a time to advocate for your right to remain economically secure in your homes and communities as you age.

“Empowered Aging: Stories of Strength”

Wednesday June 16, 6-8pm

305 N Ashland Ave Chicago IL 60607

Food and refreshments provided

Parking available. Public transit close by. Take CTA Ashland bus or Green/Pink Line to the Ashland Stop

This event will feature a panel of older adults speaking about their lives, with the theme of “Empowered Aging: Stories of Strength”.

The event will be interactive, with a moderator asking questions posed by YOU, Chicago Bridge members. Please keep an eye out prior to the June Event for an email asking for your input on the panel.

Please join us to see the triumphs and challenges of aging through the eyes of inspiring individuals. Short bios and more information will be forthcoming in the next few weeks prior to the event. Email kristen.pavle@gmail.com